Case 2, presented by John S. Blanco, MD and Christopher J. Dy, MD, MSPH, describes a 4-year-old boy who presented with an injury to his dominant right upper extremity three months following a playground fall. Upon exam he was found to have an obvious deformity about his elbow with a prominent radial head laterally and restricted supination and pronation. His radiographs revealed a lateral radial head dislocation along with a radially angulated proximal ulna fracture (Bado Type III Monteggia injury). Following reconstructive treatment with the Pediatric Orthopaedic Service at Hospital for Special Surgery and physical therapy for range of motion, the patient healed uneventfully and remains asymptomatic with full range of elbow motion and fully functional at 4 years post reconstruction.